Hepatitis C transmission and treatment in contact networks of people who inject drugs.
Hepatitis C virus (HCV) chronically infects over 180 million people worldwide, with over 350,000 estimated deaths attributed yearly to HCV-related liver diseases. It disproportionally affects people who inject drugs (PWID). Currently there is no preventative vaccine and interventions feature long tr...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3815209?pdf=render |
| _version_ | 1818305033487253504 |
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| author | David A Rolls Rachel Sacks-Davis Rebecca Jenkinson Emma McBryde Philippa Pattison Garry Robins Margaret Hellard |
| author_facet | David A Rolls Rachel Sacks-Davis Rebecca Jenkinson Emma McBryde Philippa Pattison Garry Robins Margaret Hellard |
| author_sort | David A Rolls |
| collection | DOAJ |
| description | Hepatitis C virus (HCV) chronically infects over 180 million people worldwide, with over 350,000 estimated deaths attributed yearly to HCV-related liver diseases. It disproportionally affects people who inject drugs (PWID). Currently there is no preventative vaccine and interventions feature long treatment durations with severe side-effects. Upcoming treatments will improve this situation, making possible large-scale treatment interventions. How these strategies should target HCV-infected PWID remains an important unanswered question. Previous models of HCV have lacked empirically grounded contact models of PWID. Here we report results on HCV transmission and treatment using simulated contact networks generated from an empirically grounded network model using recently developed statistical approaches in social network analysis. Our HCV transmission model is a detailed, stochastic, individual-based model including spontaneously clearing nodes. On transmission we investigate the role of number of contacts and injecting frequency on time to primary infection and the role of spontaneously clearing nodes on incidence rates. On treatment we investigate the effect of nine network-based treatment strategies on chronic prevalence and incidence rates of primary infection and re-infection. Both numbers of contacts and injecting frequency play key roles in reducing time to primary infection. The change from "less-" to "more-frequent" injector is roughly similar to having one additional network contact. Nodes that spontaneously clear their HCV infection have a local effect on infection risk and the total number of such nodes (but not their locations) has a network wide effect on the incidence of both primary and re-infection with HCV. Re-infection plays a large role in the effectiveness of treatment interventions. Strategies that choose PWID and treat all their contacts (analogous to ring vaccination) are most effective in reducing the incidence rates of re-infection and combined infection. A strategy targeting infected PWID with the most contacts (analogous to targeted vaccination) is the least effective. |
| first_indexed | 2024-12-13T06:20:09Z |
| format | Article |
| id | doaj.art-ef7617f07e9444e6b86512dc57951b97 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T06:20:09Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ef7617f07e9444e6b86512dc57951b972022-12-21T23:56:52ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01811e7828610.1371/journal.pone.0078286Hepatitis C transmission and treatment in contact networks of people who inject drugs.David A RollsRachel Sacks-DavisRebecca JenkinsonEmma McBrydePhilippa PattisonGarry RobinsMargaret HellardHepatitis C virus (HCV) chronically infects over 180 million people worldwide, with over 350,000 estimated deaths attributed yearly to HCV-related liver diseases. It disproportionally affects people who inject drugs (PWID). Currently there is no preventative vaccine and interventions feature long treatment durations with severe side-effects. Upcoming treatments will improve this situation, making possible large-scale treatment interventions. How these strategies should target HCV-infected PWID remains an important unanswered question. Previous models of HCV have lacked empirically grounded contact models of PWID. Here we report results on HCV transmission and treatment using simulated contact networks generated from an empirically grounded network model using recently developed statistical approaches in social network analysis. Our HCV transmission model is a detailed, stochastic, individual-based model including spontaneously clearing nodes. On transmission we investigate the role of number of contacts and injecting frequency on time to primary infection and the role of spontaneously clearing nodes on incidence rates. On treatment we investigate the effect of nine network-based treatment strategies on chronic prevalence and incidence rates of primary infection and re-infection. Both numbers of contacts and injecting frequency play key roles in reducing time to primary infection. The change from "less-" to "more-frequent" injector is roughly similar to having one additional network contact. Nodes that spontaneously clear their HCV infection have a local effect on infection risk and the total number of such nodes (but not their locations) has a network wide effect on the incidence of both primary and re-infection with HCV. Re-infection plays a large role in the effectiveness of treatment interventions. Strategies that choose PWID and treat all their contacts (analogous to ring vaccination) are most effective in reducing the incidence rates of re-infection and combined infection. A strategy targeting infected PWID with the most contacts (analogous to targeted vaccination) is the least effective.http://europepmc.org/articles/PMC3815209?pdf=render |
| spellingShingle | David A Rolls Rachel Sacks-Davis Rebecca Jenkinson Emma McBryde Philippa Pattison Garry Robins Margaret Hellard Hepatitis C transmission and treatment in contact networks of people who inject drugs. PLoS ONE |
| title | Hepatitis C transmission and treatment in contact networks of people who inject drugs. |
| title_full | Hepatitis C transmission and treatment in contact networks of people who inject drugs. |
| title_fullStr | Hepatitis C transmission and treatment in contact networks of people who inject drugs. |
| title_full_unstemmed | Hepatitis C transmission and treatment in contact networks of people who inject drugs. |
| title_short | Hepatitis C transmission and treatment in contact networks of people who inject drugs. |
| title_sort | hepatitis c transmission and treatment in contact networks of people who inject drugs |
| url | http://europepmc.org/articles/PMC3815209?pdf=render |
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